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General NPI Number Information
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NPI Number | 1205820198
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Entity Type | Individual
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Provider Name | SUSAN K KAUFFMAN LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 146 DEPOT ST STE 202
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City | BLUE RIDGE
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State | GA
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Zip | 30513-8503
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Country | US
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Telephone | 706-964-6111
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Fax | 706-964-6111
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Provider Business Mailing Address
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Address Line | PO BOX 1157
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City | MC CAYSVILLE
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State | GA
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Zip | 30555-1157
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Country | US
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Telephone | 941-780-4192
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Fax | 706-964-6111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH2837
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License Number State | FL
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